The goal of the training program is to increase significantly opportunities for students, primary care residents and fellows of the Mount Sinai Medical Center to learn the principles and practice of environmental and occupational medicine. Although the Mount Sinai School of Medicine has extraordinary resources for training in environmental and occupational medicine based on the nationally recognized occupational medicine program located in the Division of Environmental and Occupational Medicine of the Department of Community Medicine, there is a significant need for expanding the environmental medicine curriculum available to students and primary care residents in the Medical Center. Currently, there is no required time in the medical school curriculum devoted explicitly to teaching environmental medicine and only a few students each year take elective courses or rotations in the field. Specific objectives of the program are: to increase awareness of students about environmental and occupational disease through coordination of the teaching of pertinent topics in current courses; to present new lectures about the field in required courses; to increase opportunities for teaching environmental medicine in the clinical setting by identifying patients with potential environmentally related diseases in order to provide teaching consultations; and to enhance elective offerings in environmental and occupational medicine for students and residents. Tasks that will be undertaken in order to accomplish the objective include the following: convene an Environmental and Occupational Medicine Curriculum committee for the purpose of advising the candidate on implementation of the curriculum; develop new teaching materials for faculty and trainees that illustrate the importance, principles, and fundamental skills of the field; enhance existing electives in environmental medicine and offer new electives that are responsive to the needs of trainees; initiate a liaison consultation service in environmental and occupational medicine and a hospital-based surveillance system in order to identify patients with potential environmentally related diseases, and provide teaching consultations to students and residents on the evaluation and management of these patients; and conduct a systematic evaluation of the implementation of the training program. Significant support for the proposed training program by the Mount Sinai School of Medicine is demonstrated by letters of commitment to participate in the training activities or curriculum committee by more than 20 key members of the faculty. New commitments for access to time in required lectures for teaching environmental and occupational medicine have been made by course directors in the preclinical curriculum and by the Departments of Medicine; Pediatrics; Obstetrics, Gynecology, and Reproductive Science; and Neurology.